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Author
Topic: united healthcare (Read 8752 times)

What about this new policy of United Healthcare that requires us to purchase HIV meds only via mail from a pharmacy of their choice?For me it is a great inconvenience since I am rarely home and I certainly do not want my med delivered to a neighbor or, worst at work.I want to be able to pick my stuff myself at a time and place of my convenience.What is also very upsetting is that they are spinning this restriction as a better way to serve us.In my view it is discriminatory and makes me very angry....

my prescription plan is the same way and it has been for years now. They sent me a nasty letter saying they would not cover my meds if I didn't order it in the mail and I threatened them with a law suit.I used to travel a lot and was away too much. I told them I never knew where I was going to be, so home delivery was not an option.I still get my meds from Wallgreens. That is one of the good things HIV has done to me. I am not afraid to speak my mind and stand my ground. My attitude is basically "Don't fuck with me, I don't have the time".

Rich(who has thrown quite a few shows at hospitals and pharmacies)

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POSITIVE PEDALERS... We are a group of people living with HIV/AIDS, eliminating stigma through our positive public example.

That's ridiculous. I can't believe insurance companies sometimes. My insurance (Aetna) makes it financially absurd not to do the mail order option. It is indeed a hassle as I also travel quite often but the difference is 6X cheaper.

What about this new policy of United Healthcare that requires us to purchase HIV meds only via mail from a pharmacy of their choice?For me it is a great inconvenience since I am rarely home and I certainly do not want my med delivered to a neighbor or, worst at work.I want to be able to pick my stuff myself at a time and place of my convenience.What is also very upsetting is that they are spinning this restriction as a better way to serve us.In my view it is discriminatory and makes me very angry....

I hadn't even heard about this and I have United!

I will say that I did use their mail order program a couple months back because it was a cost savings. I paid $40 for 3 months of meds so I'm not gona gripe about that.

One odd thing, they delivered on med one day and then I got the second one on the following day. I was sort of worried because they were sitting out in the heat, but the pharmacy rep. said Sustiva and Truvada didn't have temp. issues. He said if the drug was temp. sensitive they do ship in coolers etc.

I still worried though what if it got sent to a neighbor or some screw up and meanwhile my $5 grand worth of pills are lost. Anyways, they allege in that event they will express mail a replacement.

It's a huge money-saver with my plan, too. This year they started a new thing where I can get the mail-order price and qty but pick it up in person at Wal-Mart. Supposedly they're adding Walgreen's next year. I have a $60 annual deductible that doesn't apply to generics or mail-order, and haven't needed anything else this year, until today, when I got screwed and paid $85.00 for a 30-day supply of Advair.

I'm sorry to hear that about United, though. I had them years ago and never had a problem or anything outrageous imposed on me.

This may be for another thread but why is it a "HUGE SAVER" ? Are they shipping from Canada or what?

Milker.

One of my meds is $47/month if I get a one-month supply, but $60 if I get a three-month supply--$81 savings. The $60 price is the same for all name-brand drugs. If the monthly pick-up price was $500, I'd still get a three-month supply for a flat $60. Originally I had to order it from their mail-order pharmacy, but now I can pick it up at Wal-Mart.

One of my meds is $47/month if I get a one-month supply, but $60 if I get a three-month supply--$81 savings. The $60 price is the same for all name-brand drugs. If the monthly pick-up price was $500, I'd still get a three-month supply for a flat $60. Originally I had to order it from their mail-order pharmacy, but now I can pick it up at Wal-Mart.

The insurance companies want us to use the mail pharmacy because they are able to negotiate cheaper costs for the drugs -- which is why our co-pays are less. I see nothing wrong in being required to use the mail pharmacy for "maintenance" medications. That is, of course, assuming they will bend the rules for people like Pozattitude whose travel schedule would make this too burdensome.The way I see it -- I'm happy to take a morning off work every 2-3 months to wait at home for the $7,000 worth of meds that are coming for which I pay $250.We all like to piss and moan about the cost of healthcare, but we don't want to do anything ourselves to help control it. (Of course, big Pharma could be doing something to help lower the cost of healthcare, but that's a story for another thread )

Mike(who feels compelled to note that, while I am not required to use mail pharmacy by Aetna, I do so to save myself about 75% in co-pays)

As far as I understand - most of these restrictions are policy specific and not specific to the company. For instance, I have UHC through work and our RX is through Medco - if I were on Meds, I could go to a pharmacy and get them for $50 per month / each or Mail Order through Medco and get them 90 days for $50 - It's such a cost saver.

My mail order pharmacy prefers to send my medicines via UPS, Next Day Air. They do this free of charge for me. They told me that it is because of the cost of my medicines. I could sign a waiver to have it sent by the post office, but they said if I do this and it gets "lost", they will not replace them. So --- Next Day Air is supposed to be here by 10:30 in the morning -- I simply take the morning off or work from home that morning. Anything to save a few bucks!

When I was on Fuzeon, PacifiCare (which has merged with United) required me to get the Fuzeon through their mail order pharmacy. I could use my local pharmacy for all my other meds.

Getting the Fuzeon was no problem, except every three months, when I had to get the prescription renewed or get a new authorization from my medical group. Then it would be a major hassle. My doctor's office would fax the prescription and authorization to the mail order pharmacy, and they would claim they didn't get it. This would go on for as many as four attempts. I know that my doctor's office was using the correct fax number; they had proof that the faxes had been sent and received. It would take many phone calls on my part and by the nurses in the clinic to get it all straight.

I should add that in addition to the faxes, hard copies of the prescription renewals and authorizations were sent by regular mail to the mail order pharmacy. They claimed they never received those hard copies. I felt like my mail order pharmacy was located in the Bermuda Triangle. All communications to them seemed to disappear.

I have never had any problems with my local pharmacy. They know me and go out of their way to ensure that I receive my meds on time.

I'm no longer taking Fuzeon, so I can get everything at my pharmacy. It is much less stressful for me. I dread getting a letter from my insurer saying that I will have to get all my meds through the mail.

I dont like hearing this about United as that is the only option that my employer offers. I have not had any problems yet (knock on wood) but have only been on meds for two months. My companies plan was effective here May 1st so is that a new change that is coming up for me next year? I do have the UHC Choice Plan so I dont know if that is the diffrence. I get everything through Walgreens. I do know that for this plan year that the Dr is not allowed to draw blood and if they do then I have to pay an additonal co-pay. So they send me down two floors to LabCorp (who has messed up two tests so far) to draw the blood and do the lab work. Just another way to make it inconvient for us.

I have used mail-order through various insurance plans for my maintenance meds for almost ten years. I do it gladly, as I am mindful of the difference in amounts charged between retail and mail-order--even WalMart is marking up meds significantly. I understand why two prescriptions ordered at the same time can come a day apart, as Medco does not always have everything in stocck.

My challenge is always getting my orders in synch, just for my sanity. I see the psychiatrist every 3 months, and he writes a new prescription for Stratera and Adderall each time--Adderall is legal speed, so it requires an original each time with no refills. My primary writes for my Lisinopril with three refills to get me through a year. He put me on acyclovir two months ago which I've been doing retail, but to save myself a whopping 4 bucks for three months, I'm having him send me a prescription for mail order; and I'm sitting on the ADD meds Rxs and the Lisinopril re-order til the acyclovir Rx arrives.

As for lab charges, most physicians will attempt to charge insurance for a venipuncture service if they draw blood. Labcorp and Quest do not--it's rolled into the charge for a test. Quest was not competitive in its bid for UHC business, so it got dropped as the preferred (no cost) lab. Either way, I hate having to complain more times than not because the phlebotomists will not listen and just use a pediatric needle in the back of my hand the first time like I instruct.

They charge me the same copay of my regular pharmacy, therefore is no saving for me>My issue is that I work long hours and I travel a lot, I live in a small buildind with nosy neighboor and I cannot risk to have my med shipped at my workplace.I see this more of an imposition and quite frankly I think we are getting less and less and the premiums we pay keeps going up.

I won my battle: bioscript, the pharmacy they are using, has a store in NYC where I can pick up my meds.They were bulking at the beginning and it took quite a few angry phone calls, but at the end they obliged

While I don't use UHC, I do use Medco. They threatened me in the beginning to force me to go with mail-order, but since my income is limited, ADAP covers my co-pays. And Medco will not cooperate with ADAP - no way, no how!So, I use a gay-friendly pharmacy out of the Los Angeles area. They send me my meds by mail every month and take care of all of the hassles between the two insurances.If any of your meds are covered by ADAP, I can almost assure you that UHC will run the other way and not penalize you for getting your meds every month from the pharmacy of your choice.

I won my battle: bioscript, the pharmacy they are using, has a store in NYC where I can pick up my meds.They were bulking at the beginning and it took quite a few angry phone calls, but at the end they obliged

squeaky wheel gets the oil

good for you!

Rich(who has learned how to throw a fit when dealing with insurance companies)

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POSITIVE PEDALERS... We are a group of people living with HIV/AIDS, eliminating stigma through our positive public example.

I have my meds sent to me at the office through UPS... I have Blue Cross Blue Shield and Med Express is the pharmacy... I've never had a problem... med express is always prompt with arranging and sending my drugs... the meds are in a box... so what if the label shows its meds... theres not a description etc... of the types listed... plus I do not have to worry if my medication is left out in the sun... its convient... I've been doing this for years... plus everyone in my office has some sort of medical problem... I guess were all getting older... its a rareity to find someone whose in perfect health anywhere... I recieve my meds monthly never thought about once every 3 months... I'll have to check on that...

Congratulations on your win! How long did you have to fight to get this override?

I have the UHC plan too and was informed that I have the choice of using bioscript OR staying with my current pharmacy, paying for my meds out of pocket, and then of course getting partially reimbursed because my current pharmacy is 'out of network' for my Atripla. Yes I was on the phone for a few hours trying to understand WHY they think this is better for me. Like the rest of you, I travel a lot, so I'm trying to figure out where I'm supposed to get the meds delivered. The pharmacy rep kept saying that they could deliver 'anywhere in the continental US'. I pointed out that was great, but 1. I didn't necessarily know from month to month where I would be and 2. I needed to be able to sign for it. Their reply was 'You don't have to sign for it, but if it is missing we aren't responsible.' I took a deep breath and then responded that I would think that a $1400 bottle of medicine should HAVE to be signed for. Sigh.... The other 'benefit' to me is that the pharmacists at bioscript 'understand' the possible complications and drug interactions with with my medications as well as be able to answer questions or concerns that I might have. So then I asked if I had to switch all my perscriptions to bioscript (i.e. dieuretic and alllergy medicine) and they told me no. So I asked, 'how would you know what the drug interactions would be if you don't have all my medications?' Again no answer. I also asked about how a pharamist that I would NEVER see be able to help me? Again no answer.

I didn't really know that I had much recourse before I saw your post. But I will need my meds next week so I'm not sure what to do at the moment. Part of me is waiting to see what will happen because I'm interviewing and hoping to get a new job within the next month or so... But I need to be prepared to fight, because I seriously didn't want to have to have my meds sent to my sister's job so that I can be sure to get it on time.

Sorry for the rambling, I was just happy to know that people had successfully fought this 'helpful hand' that UHC is providing.

Ty

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i told them that I would take them to court and use all remedies at my disposal. In the end we reached a compromise, since Bioscrip has a store in NYC (Chelsea) and I can get my meds there.Maybe we should contact some organization and try a class lawsuit.

Ok, so you won your "battle" with the big bad insurance company, why the hell do you want to sue them now?? I think that it is the duty of insurance companies to try and keep costs as low as they can. That is the whole point in their requiring use of their mail order pharmacy. They showed that they can be flexible (yes, you had to fight a bit, but they did see the light -- and you aren't the only one who has come to a compromise with them). Everyone loves to complain over how expensive health care is in this country and then we all turn around and want everything EXACTLY as we want it (Yes -- I am including myself in this). The fact is, they are paying for most of the cost of our medicine, so some small inconvenience on our parts should not be a huge deal. When it gets beyone an inconvenience -- like in your case, with a traveling job -- then compromise is in order.We all have a choice, if we don't like what the insurance company requires -- we can leave and pay ourselves. Of course, who can afford that?? Not me! But that isn't the insurance company's fault, now is it.

Sorry for the rant, but I get ticked when people can't see how lucky they are to have insurance that pays for medicines when millions around the world would give their left arms for this "inconvenience".

Given Virtitalicus' circumstances, I think his request not to have his meds delivered at home was entirely reasonable. And it seems clear to me that since they reached a compromise that enables him to pick up his drugs at the Bioscript store, he will not be suing.

I got the notice about using bioscrip yesterday and from what I was informed was that they could only fill one month. Right now my delimmia is this....there are no refils on my current meds, going to the DR on the 30th for blood work and new scrips, leaving town that day for the labor day weekend and duing that time will be running out of meds Once my Dr faxes BioScrip it takes 24 hrs to process, then they FedEx them, which means I wont get them till I get back on the 3rd. The solution to this is that I pay for the drugs out of pocket ($1,000+) and then submit the claim to UCH to have them send me a check less my co-pay. I dont have this kind of money laying around. It is much for convient for me to go to Walgreens and pick them up. It also sounds like they are moving all "tier 2" and higer "tiers" to this pharmacy. And since I dont use credit/debit cards I must mail order my co-pay in first then they will process my order, but they cant tell me what my co-pay is untill they go to fill the meds. Fucking UHC.

bocker3,Given Virtitalicus' circumstances, I think his request not to have his meds delivered at home was entirely reasonable. And it seems clear to me that since they reached a compromise that enables him to pick up his drugs at the Bioscript store, he will not be suing.I think you misread what Viritalicus wrote.Allan

So, I agree that his request was reasonable (and said that in my post). However, I don't think I misread anything -- he said, "Maybe we should contact some organization and try a class lawsuit" in his last post.

I actually said that we should sue, for all the others who have not been able to reach a compromise.I am also of the opinion that healthcare is a right for everyone and I do not give a damm about the cost of it:we are spending billion of taxpayers dollars in a useless and absurd war....don't get me started

I actually said that we should sue, for all the others who have not been able to reach a compromise.I am also of the opinion that healthcare is a right for everyone and I do not give a damm about the cost of it:we are spending billion of taxpayers dollars in a useless and absurd war....don't get me started

I agree that healthcare should be a right. However, at the moment, there isn't the political will to make that change in the US (there have been many threads on this), so we have to deal with what we've got - we can advocate for change, but we must deal with what we have today. Suing an insurance company is NOT going to make the US gov't finally do something about Universal Healthcare. All it will do is continue to drive the cost up for you and me and everyone else as the healthcare industry puts more money toward lawyers and defensive medicine -- which will lead to LESS (not more) people being able to get their healthcare covered. So perhaps we all DO need "to give a damm about the cost of it".This thread has nothing to do with whether or not you can get your healthcare -- clearly you can. What was originally in question (by me) was whether, under the current system, we should expect to get whatever we want, however we want. I think that answer is only yes if we are willing to pay for it ourselves (again -- given the system we have). If we expect "someone else" to pay, we may need to be somewhat inconvenienced. Again, I think your request was reasonable and am very glad that UHC compromised with you.Please don't confuse the issue of where/how care is delivered with whether any care is delivered.By the way -- even if we had Universal Care, do you think you'd be able to go whereever you wanted to receive it? I doubt it.

I actually said that we should sue, for all the others who have not been able to reach a compromise.I am also of the opinion that healthcare is a right for everyone and I do not give a damm about the cost of it:we are spending billion of taxpayers dollars in a useless and absurd war....don't get me started

Viritalicus, unless you are totally inept and don't remember the World Trade Center, the Pentagon, and the plane that went down in Pennsylvania on 9/11, then I guess you wouldn't understand. Would you rather there be car bombings here? More buildings blown up here or would you prefer having it all take place in their court? This country is still screwed up over 9/11 and whatever it takes to keep it from happening here again, I'm all for it, what ever the cost. Universal Health Care won't help anyone that is dead. The US has the money to provide more health care, their problem is on Capital Hill, how to accomplish it and manage it. As you've already seen, anything that our government sticks its hands in, usually gets totally screwed up, no matter what political party is in office.

I guess I must be as "inept" as Viritalicus, but I fail to see RapidRod's connection between WTC and Universal Health Care, which is available in every civilized country in the Western world except for ours. We don't have UHC because of insurance companies and phamaceutical companies paying off our elected officials and Republican propaganda about "socialized" medicine. The attack on the World Trade Center has nothing to do with this.

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"No one will ever be free so long as there are pestilences."--Albert Camus, "The Plague"

"Mankind can never be free until the last brick in the last church falls on the head of the last priest."--Voltaire

I actually said that we should sue, for all the others who have not been able to reach a compromise.I am also of the opinion that healthcare is a right for everyone and I do not give a damm about the cost of it:we are spending billion of taxpayers dollars in a useless and absurd war....don't get me started

edfu, as normal you didn't read the posts and then you make assumptions. She called spending billions of taxpayer dollars in a useless and absurd war. That edfu was what I was responding to. That was an inept remark. edfu, make sure you have read and understand the post before you go commenting and yes edfu most of your comments are inept which I have to totally agree with you.

The majority of U.S. citizens regard the war in Iraq as useless and absurd; it has done nothing to protect us from terrorists. If anything, the war has increased the possibility of terrorism. I have made no assumptions, and I know how to read. Unfortunately, it is impossible for you to understand that there is no connection between Iraq and Universal Health Care when all you can respond is with personal name-calling. Your knowledge is as complete as your very own assumption that I didn't "read the posts."

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"No one will ever be free so long as there are pestilences."--Albert Camus, "The Plague"

"Mankind can never be free until the last brick in the last church falls on the head of the last priest."--Voltaire

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

This may be a bit of good news for some of us out there. I called my Dr and asked them about this new policy, they told me that due to my plan having pharamicy beneifts I can continue to fill my RX's in town. You may want to contact UCH and find out if your plan has the pharmaicy benefits to avoid using their choice pharmaices.

As far as I understand - most of these restrictions are policy specific and not specific to the company. For instance, I have UHC through work and our RX is through Medco - if I were on Meds, I could go to a pharmacy and get them for $50 per month / each or Mail Order through Medco and get them 90 days for $50 - It's such a cost saver.

You're right! My plan doesn't have this mandatory RX by Mail program and I have United. Regardless, I still used the mail order program because I got 3 months of meds shipped last week for $40 so I am not complaining! I can think of a lot of other things I'd rather spend that $80 I saved on.

Live Love Laugh and dance like no ones watching.Laughter is the best medicine, so try to have a laugh everyday..Even if your not feeling your best, think about something that was funny at one time in your life and work with it.. )

I just got my 3-month supplies of Lisinopril, Adderall, and acyclovir for $60 total through Medco/United, with insurance picking up $262.

A few weeks ago I had an EMG done on my forearms and hands at Georgetown University Medical Center to re-confirm carpal tunnel syndrome. Procedure was done by a hot young resident under the watchful eye of an experienced neurologist who then "interpreted" the results. United paid the full $383.30 for the cute guy to do electroplay with me, but they knocked the interpretation bill back from $486.00 to $162.60, sticking me with no responsibility for the difference!